Positive tools for thriving families.

Recently, I read a very informative article by Dr. Tynan (Director of Integrated Health Care, American Psychological Association Center for Psychology and Health) on the stunning number of young children who are diagnosed and medicated for attention-deficit-hyperactive disorder (ADHD) in the United States.  The article states that an estimate of almost two hundred thousand 2-5 year olds have been diagnosed with attention-deficit-hyperactive disorder. This statistic is shocking in itself, as currently there are no valid criteria for ADHD in children this young. Two to five year olds are very immature, are changing rapidly, and are always on the move based on developmental norms. So it is very concerning to learn about the high number of children being given such a serious diagnosis so early in their development.

The Journal of Pediatrics and the Center for Disease Control and Prevention have also recently reported on a very important national study on treatment interventions for ADHD across all ages. The findings from the report show the following:

  • “9 out of 10 children with ADHD were treated with medication and/or behavioral therapy, both of which are recommended ADHD treatments. Of these children:
    • about 4 in 10 (43%) were treated with medication — the most common single ADHD treatment,
    • about 1 in 10 (13%) received behavioral therapy alone, and
    • about 3 in 10 (31%) were treated with combination therapy (medication and behavioral therapy).
  • About 1 in 10 children with ADHD were receiving neither medication treatment nor behavioral therapy.
  • About 1 in 10 were taking dietary supplements for ADHD, which are not currently recommended for the treatment of ADHD.”

Dr. Tynan accurately points out the significant concerns related to the above findings in that “since 2011, the treatment guidelines from the American Academy of Pediatrics have recommended that preschoolers diagnosed with ADHD receive behavioral therapy first before medication. But, almost 50% of diagnosed preschoolers received no behavioral therapy. Too many are being treated with stimulants and other psychoactive medications as the sole form of treatment.”

Given that there is currently very little research that demonstrates the safe effectiveness of medications in young children, and given the number of side effects medications can have on young children, it is imperative that we continue to turn to behavioral and family treatment, along with effective school and classroom interventions (including teacher trainings, and changing the classroom structure, demand, and flow) to better meet the developmental needs of younger children. Perhaps changes in our approach and expectations for active and high-energy children may be more safe and effective in the long run for the child and the family.

In fact, based on a review of the research on ADHD and behavioral interventions, the CDC’s National Center for Injury Prevention and Control reports that positive parenting, effective communication and discipline, and social rewards and praise can be very powerful tools in managing young children’s behaviors and outcomes. Hence, based on a meta-analyses of many studies, the CDC has recently published a set of videos and tools to teach effective parenting skills on a new website: Essentials for Parenting.

As clinicians, pediatricians, teachers, and parents it is important for us to pay attention to the outlined concerns and utilize these listed resources to the best of our abilities in helping our youngest generation thrive.


Leave a Reply

Your email address will not be published. Required fields are marked *

five × four =

  • Exceptional, impressive, thoroughly 'kid friendly' from beginning to end, "Family Changes: Explaining Divorce to Children" should be a part of every community library Parenting Studies collections. For families with young children who are having to deal with divorce, "Family Changes: Explaining Divorce to Children" will prove to be an invaluable and instructive aid.

    Editor in Chief - Midwest Book Review

  • Those of us parenting, working with, or caring for children experiencing divorce will welcome Family Changes as a unique, positive, and creative resource for helping children understand and cope with this complicated transition. The comprehensive note to adults effectively explains how children work through painful questions and feelings. The touching story—with the endearing Zoey and her attempt to understand a very grown up topic—ends with extremely helpful follow up questions that will be highly valued by parents, child advocates, therapists, and others who wish to better serve children during this difficult time. I highly recommend this book to parents and professionals.

    Sacha Coupet, Ph.D., J.D. Clinical Psychologist and Associate Professor of Family Law, Loyola University, Chicago, IL

  • Family Changes: Explaining Divorce to Children is an outstanding book that is gentle, positive, and validating for both children and adults. With an excellent and informative parent guide about the value of talking to children about their feelings, a highly sensitive and engaging story with exquisite illustrations, and an effective list of questions that children typically ask, this book is essential reading for divorcing families, and for therapists and advocates working with children of divorce.

    Sandra A. Graham-Bermann, Ph.D., Professor of Psychology and Psychiatry, University of Michigan

  • Family Changes is an inspiring and exceptional book on divorce. It explains divorce in a developmentally appropriate and comforting language that validates children's complex feelings about divorce. Dr. Maker's expertise and years of experience working with children who are coping with the grief and confusion that often accompany divorce shine through in every page. I highly recommend this book to divorcing parents, schools, libraries, and professionals working with children of divorce.

    Martha Crowe, M.A. Child Development, Institute for Public Health, San Diego State University, CA

  • Dr. Maker has brought us this excellent child-centric educational book about how to navigate the changes of a family undergoing divorce. Dr. Maker takes us through this experience from the child's point of view and shares the gift of positive transformation that can occur during this life-changing time. The illustrations are sublime and the topic is handled so gently and ingeniously. Of course, it is written by a child psychologist with the gift of creativity. It's a book that every child therapist, library, school, and families going through a divorce should have on their shelves.

    Krista Royabal, M.D., Psychiatrist, Executive Medical Director, True Life Center for Wellbeing, CA

  • Based on the typical emotional turbulence a child feels from separation or divorce, Family Changes receives high recommendation as the first title that adults should turn to in the effort to explain, explore, and support a child's feelings in the matter, concluding with a list of 'process questions' which adults can use to further enhance the story line's overall approach.

    CA Bookwatch/Donovan’s Literary Services/Recommended Reading

  • The story touches on several key issues that children worry about - will their parents still love them, will they have two homes now, did they somehow cause the divorce, etc. The book also opens with a straightforward Note to Adults and ends with a list of questions that adults can discuss with children. Often books that do a good job of explaining divorce and separation are so focused on the child's point-of-view, that they don't offer any advice for the parents, caregivers, and teachers that are trying to help the child makes sense of it all. Family Changes avoids that problem and gives good guidelines for adults. I would recommend this book to parents and other family members, educators, and counselors.

    NetGalley Reviews/The Fairview Review - Librarian

  • This story is filled with little moments that reflect the nature of children perfectly. If you need to explain what it means to be divorced or separated to your child then this is one of the best ways to do that. The book is filled with relatable emotions and questions that a lot of children will have if their family is going through a separation. Dr. Maker’s years of experience are evident in the story as she masterfully addresses many common concerns for children experiencing a divorce in their family.

    The Littlest Bookshelf